MRI detection of early blood-brain barrier disruption: parenchymal enhancement predicts focal hemorrhagic transformation after thrombolysis.
Stroke
; 39(3): 1025-8, 2008 Mar.
Article
en En
| MEDLINE
| ID: mdl-18258832
ABSTRACT
BACKGROUND AND PURPOSE:
Blood-brain barrier disruption may be a predictor of hemorrhagic transformation (HT) in ischemic stroke. We hypothesize that parenchymal enhancement (PE) on postcontrast T1-weighted MRI predicts and localizes subsequent HT.METHODS:
In a prospective study, 33 tPA-treated stroke patients were imaged by perfusion-weighted imaging, T1 and FLAIR before thrombolytic therapy and after 2 and 24 hours.RESULTS:
Postcontrast T1 PE was found in 5 of 32 patients (16%) 2 hours post-thrombolysis. All 5 patients subsequently showed HT compared to 11 of 26 patients without PE (P=0.043, specificity 100%, sensitivity 31%), with exact anatomic colocation of PE and HT. Enhancement of cerebrospinal fluid on FLAIR was found in 4 other patients, 1 of which developed HT. Local reperfusion was found in 4 of 5 patients with PE, whereas reperfusion was found in all cases of cerebrospinal fluid hyperintensity.CONCLUSIONS:
PE detected 2 hours after thrombolytic therapy predicts HT with high specificity. Contrast-enhanced MRI may provide a tool for studying HT and targeting future therapies to reduce risk of hemorrhagic complications.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Barrera Hematoencefálica
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Terapia Trombolítica
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Hemorragia Cerebral
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Isquemia Encefálica
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Accidente Cerebrovascular
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Humans
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Middle aged
Idioma:
En
Revista:
Stroke
Año:
2008
Tipo del documento:
Article